title: Optimum repair for massive ventral hernias in the morbidly obese patient--is panniculectomy helpful?
abstract: BACKGROUND
  The appropriate surgical management of morbidly obese patients with symptomatic hernias is not well defined. The authors evaluated the role of simultaneous panniculectomy in complex abdominal wall reconstruction.
  
  
  METHODS
  A retrospective study (2007-2010) was conducted of morbidly obese (body mass index > 40 kg/m(2)) patients undergoing open complex abdominal wall reconstruction.
  
  
  RESULTS
  Thirty patients were identified. Twenty underwent simultaneous panniculectomy. The median pannus weight was 5.2 kg. Greater all-cause postoperative complications and wound-related morbidity occurred in the panniculectomy group (P < .05). Performing a panniculectomy increased the risk for a wound complication by 5-fold (P = .04). Following 7-month to 9-month follow-up, both groups had a recurrence rate of 10%.
  
  
  CONCLUSIONS
  Simultaneous panniculectomy in the setting of complex abdominal wall reconstruction is feasible but associated with significant postoperative morbidity. Its potential for benefit in reducing long-term hernia recurrence remains unclear.
authors.affiliation: Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve School of Medicine, Cleveland, OH, USA. karem.harth@uhhospitals.org
authors.forename: Karem C
authors.initials: KC
authors.lastname: Harth
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Blatnik
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rosen
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D006801:Humans; D015187:Lipectomy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D009820:Ohio; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing